Successful treatment of mycotic hepatic artery pseudoaneurysms with arterial reconstruction and liposomal amphotericin B.
A 55-year-old woman developed end-stage liver disease and the hepatorenal syndrome secondary to cryptogenic cirrhosis. Orthotopic liver transplantation was complicated by bile peritonitis, requiring reoperation and eventual placement of an internal biliary stent. On postoperative day 26, hemobilia was caused by localized rupture of mycotic (Aspergillus fumigatus) hepatic artery pseudoaneurysms with fistulization into the biliary tree. After arterial reconstruction with a reversed autologous saphenous vein graft, the patient was treated successfully with liposomal amphotericin B.
Rudich
S M
SM
Department of Surgery, University of California, Los Angeles, USA.
Kinkhabwala
M M
MM
Murray
N G
NG
See
D M
DM
Busuttil
R W
RW
Imagawa
D K
DK
D000666:Amphotericin B / Q000008:administration & dosage*; D017541:Aneurysm, False / Q000628:therapy*; D004337:Drug Carriers; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000473:pathology; D006801:Humans; D008081:Liposomes; D008875:Middle Aged; D009181:Mycoses / Q000628:therapy*; D011859:Radiography
D004337:Drug Carriers; D008081:Liposomes; D000666:Amphotericin B